Multimedia

Audio

When Augustus White was growing up in the American south in the 1940s, racial segregation was an accepted part of life. African Americans got second best - in education, employment, and health care.

But White overcame those barriers, becoming an orthopedic surgeon, professor of medicine at Harvard and a leading figure in the struggle to reduce discrimination against minority medical patients.

Overcoming barriers

White was the first African American to reach a series of academic and professional milestones that were unheard of in the 1950s and ‘60s. The first African-American president of his traditionally white fraternity at Brown University, White was the first African American to graduate from Stanford Medical School, the first black resident, the first black surgery professor - at Yale University - and the first black department chief at Harvard’s teaching hospitals.

But what White may be best known for is his groundbreaking exploration of the deeply-rooted bias against minority patients that he believes is prevalent in the American health care system.

White first became aware of discrimination against minorities at the start of his medical career in the early 1960s and, later, while serving as a combat surgeon during the Vietnam War. His personal observations were further confirmed when he read a 2002 report that revealed some disturbing statistics about discrimination, not only against blacks, but also women, Hispanics, gays, the elderly and even the obese.

"This Institute of Medicine report, "Unequal Treatment," just spells it out in just blatant, statistical, overwhelmingly convincing ideas and realities about this inhumanity that exists," he says.

It’s conscious and unconscious, says White, but it’s a prevailing situation. "When are you most vulnerable? It’s when you’re sick. And to realize that under those circumstances you’re at risk to receive disparate care is really quite an issue."

Unequal treatment

The report also cited that African Americans receive less pain medication for the same injuries than white Americans; women dying from kidney disease are less likely to receive transplants; Hispanic Americans receive less angioplasty and bypass surgery for heart disease than whites; and the elderly are treated as less valuable than younger patients.

White finds this shocking, and inexcusable. "It’s a moral issue. It’s a legal issue. It’s a public health issue. This is a question of human rights," he says. "People should be getting the best care that the profession can offer them. And now they’re not getting the best care the profession can offer them."

What was even more surprising to White was seeing just how unconscious this bias seemed to be.

"There are examples of female doctors actually giving disparate care to female patients. There are examples of African-American doctors actually giving disparate care to African-American patients. And my theory is that the culture of medicine is so powerful that when you come through it as a student and as a resident and as a young doctor, and you get inculcated into the profession, sadly, part of that momentum includes these biases."

Augustus A. White III, M.D., is professor of Medical Education and Orthopedic Surgery at Harvard Medical School and the first African American department chief at Harvard’s teaching hospitals.

Medical inertia

To counteract these discrepancies, White calls for changes in education for doctors, nurses, medical school faculty, even insurance companies. He says they need training in self-awareness, so they can recognize their internalized prejudices, and be able to work from that.

"Medical students should be taught something about the characteristics of the cultures that they may be treating in large part. So if 30 percent of your patients are Muslim patients, you should have some insight, some idea about what some of the prevailing practices of the Muslim culture may be."

With a new book about his experiences, called "Seeing Patients - Unconscious Bias in Health Care," White hopes to make the medical community aware of the problem, and trusts it will motivate them to doing something about it.

But he admits that it’s going to be a challenge.

"There is a kind of denial, there is a kind of inertia, but I think this is a mission that deserves a lot of energy and enthusiasm to get medical schools to be more committed with resources, with determination, with sustained efforts to really change the culture of medicine."

White remains hopeful that change will come - and that everyone will have equal access to the best medical care the nation can provide.

U.S. Secretary of State John Kerry has told his Russian counterpart, Sergei Lavrov, that his country could face further consequences to what he called its “already strained economy” if Moscow does not fully comply with a cease-fire in Ukraine. The two met, on Monday, on the sidelines of a U.N. Human Rights Council meeting in Geneva, where Kerry outlined human rights violations in Russian-annexed Crimea and eastern Ukraine. VOA State Department correspondent Pam Dockins reports from Geneva.

Video

U.S. Secretary of State John Kerry has told his Russian counterpart, Sergei Lavrov, that his country could face further consequences to what he called its “already strained economy” if Moscow does not fully comply with a cease-fire in Ukraine. The two met, on Monday, on the sidelines of a U.N. Human Rights Council meeting in Geneva, where Kerry outlined human rights violations in Russian-annexed Crimea and eastern Ukraine. VOA State Department correspondent Pam Dockins reports from Geneva.

Video

Diagnosing infections such as HIV requires expensive clinical tests, making the procedure too costly for many poor patients or those living in remote areas. But a new technology called lab-on-a-chip may make the tests more accessible to many. VOA’s George Putic reports.

Video

Afghan officials have expressed concern over reports of a crackdown on Afghan refugees in Pakistan following the Peshawar school attack in December. Reports of mass arrests and police harassment coupled with fear of an uncertain future are making life difficult for a population that fled its homeland to escape war. VOA’s Ayesha Tanzeem reports from Islamabad.

Video

Despite the ongoing ceasefire in Ukraine, soldiers in the city of Mariupol fear that pro-Russian separatists may be getting ready to attack. The separatists must take or encircle the city if they wish to gain land access to Crimea, which was annexed by Russia early last year. But Ukrainian forces, many of them volunteers, say they are determined to defend it. Patrick Wells reports from Mariupol.

Video

As low oil prices and Western sanctions force Russia's economy into recession, thousands of Moscow restaurants are expected to close their doors. Restaurant owners face rents tied to foreign currency, while rising food prices mean Russians are spending less when they dine out. One entrepreneur in Moscow has started a dinner kit delivery service for those who want to cook at home to save money but not skimp on quality. VOA's Daniel Schearf reports.

Video

The United States and Cuba say they have made progress in the second round of talks on restoring diplomatic relations more than 50 years after breaking off ties. Delegations from both sides met in Washington on Friday to work on opening embassies in Havana and Washington and iron out key obstacles to historic change. VOA’s Mary Alice Salinas reports from the State Department.

Video

One after another, presumptive Republican presidential contenders auditioned for conservative support this week at the Conservative Political Action Conference held outside Washington. The rhetoric was tough as a large field of potential candidates tried to woo conservative support with red-meat attacks on President Barack Obama and Democrats in Congress. VOA Political Columnist Jim Malone takes a look.

Video

New Yorkers take pride in setting world trends — in fashion, the arts and fine dining. The city’s famous biannual Restaurant Week plays a significant role in a booming tourism industry that sustains 359,000 jobs and generates $61 billion in yearly revenue. VOA's Ramon Taylor reports.

Video

Issues like the Keystone XL pipeline, fracking and instability in the Middle East are driving debate in the U.S. about making America energy independent. Recently, the American Energy Innovation Council urged Congress and the White House to make expanded energy research a priority. One beneficiary of increased energy spending would be the Brookhaven National Lab, where clean, renewable, efficient energy is the goal. VOA's Bernard Shusman reports.

Video

There has been a surge of interest in the American civil rights movement of the 1950s and '60s, thanks in part to the Hollywood motion picture "Selma." Five decades later, communities in the South are embracing the dark chapters of their past with hopes of luring tourism dollars. VOA's Chris Simkins reports.

Video

With the end of summer in the Southern hemisphere, the Antarctic research season is over. Scientists from Northern Illinois University are back in their laboratory after a 3-month expedition on the Ross Ice Shelf, the world’s largest floating ice sheet. As VOA’s Rosanne Skirble reports, they hope to find clues to explain the dynamics of the rapidly melting ice and its impact on sea level rise.

Video

A Lao dam project on a section of the Mekong River is drawing opposition from local fishermen, international environmental groups and neighboring countries. VOA's Say Mony visited the region to investigate the concerns. Colin Lovett narrates.